Fertility preservation for transgender individuals

The field of oncofertility emerged to preserve the fertilityof cancer patients whose treatment might render them as infertile or sterile.Today, the field of fertility preservation has expanded to other patientpopulations whose medical treatment may affect their fertility. One suchpopulation is transgender individuals undergoing gender affirming treatments.Although research on transgender individuals is limited overall and inparticular regarding issues surrounding reproduction, transgender individualsare interested in biological reproduction. Because various gender affirmingtreatments will permanently affect their fertility, such as hormonal treatmentand surgical removal of the gonads, it is important for transgender individualsto be offered fertility preservation before they start these treatments.

There are, however, some factors that may make fertilitypreservation difficult or less attractive of an option for transgenderindividuals. Healthcare professionals offering fertility preservation should beaware of these factors so they can help mitigate them. Here I will discuss twoof them.

First, undergoing fertility preservation treatment can bestressful for both transgender and cisgender people, but there are some uniquechallenges for transgender individuals. Individuals with gender dysphoria mayfind it particularly difficult to undergo procedures involving anatomy that isdiscordant with their identity. For example, transgender women who are asked toretrieve sperm via masturbation may find this request exacerbates their genderdysphoria and may not be possible to do. Transgender men who are asked toundergo vaginal ultrasounds may find this psychologically traumatic. Inrecognizing how fertility preservation treatment can be particularly difficultfor transgender individuals, healthcare professionals should be prepared tofind ways to alleviate these difficulties, such as by offering surgical methodsof sperm retrieval for transgender women and sedating transgender men duringvaginal ultrasounds.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.